| NPI | 1801283874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NICOLE CLARK Assistant Professor 304-293-1127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: WV 4076) |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2015-04-17 |